HCFA’s Action Plan for Y2K
The Health Care Financing Administration’s (HCFA’s) response to Y2K will have a major effect on providers, since its computer systems and those of its business partners are critical to processing claims for 70 million Medicare and Medicaid beneficiaries, says Nancy Deparle, a HCFA administrator.
"Medicare is the most automated health payer in the country," she explains. "We annually process nearly one billion claims, most electronically. In fact, 97% of inpatient hospital and other Medicare Part A claims and 81% of physician and other Medicare Part B claims are electronically submitted to the Medicare claims processing contractors. All claims undergo substantial electronic processing at the contractors, and many claims are processed to payment with no manual intervention whatsoever.
This reliance on automated systems has presented a major challenge, says Deparle. "Critical dates in computerized claims processing include the date a beneficiary became eligible, the date a patient was admitted or discharged from a hospital, the date a wheelchair rental began, or the date an enrollee entered a managed care plan," she says.
"We readily acknowledge that we got a late start with our Year 2000 problem, and that this has caused considerable concern and criticism," says Deparle. "For the remainder of 1999, we will continue to renovate, test, and retest our systems. We are ahead of schedule on our internal mission-critical systems, and we are well on our way to meeting the Federal government’s deadline for our external systems."
It is not enough for HCFA alone to be ready for the year 2000, stresses Deparle. "Health care provider computers and systems must be Year 2000 compliant in order for providers to be able to generate and submit bills to us," she says. "State computers and systems also must be Year 2000 compliant for Medicaid and CHIP (Children’s Health Insurance Program) to continue uninterrupted payment for beneficiary service."
Many states and providers will meet the Year 2000 challenge on time, but others will not, she says. "Monitoring by us and the General Accounting Office indicates that some states and providers could well fail," she adds. "This matter is of urgent concern and it literally grows in importance with each passing day."
Our provider outreach campaign features a special Year 2000 Internet site (address: http://www.hcfa.gov/Y2K) which includes some of the basic steps that can be taken by a Medicare provider or supplier, says Deparle. (See HCFA checklist on page 39.)
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content